Hyperglycemia, an abnormally high blood glucose level, usually occurs as the first sign of diabetes mellitus. High blood glucose can also occur, however, as a result of taking certain medications. Hyperglycemia can have serious medical consequences no matter what the cause, and requires treatment, either by taking medications to lower glucose levels or by stopping the offending medication.
Corticosteroids
Corticosteroids, medications used to decrease inflammation and suppress the immune response, are used frequently to treat a number of medical conditions, including autoimmune diseases and asthma and to prevent rejection after organ transplant. A July-August 2006 article in "Endocrine Practice" by lead author A. C. Donihi, M.D. of the University of Pittsburgh reported that a majority of hospitalized patients receiving high dose corticosteroids for at least two days developed hyperglycemia. Hyperglycemia that occurs initially in treatment may resolve in healthy individuals, even if they keep taking corticosteroids, according to a 1993 report in "Annals of Internal Medicine." Topical steroids can also cause hyperglycemia if used in large quantities and high doses over prolonged time periods, but this usually resolves with discontinuation of the medication.
Atypical Antipsychotics
Atypical antipsychotic medications now carry a "black box" FDA warning about the risk of developing diabetes when taking the medications. Olanzapine, sold as Zyprexa, carries the highest risk of this class of drugs, with aripiprazole, sold as Abilify, and ziprasidone, sold as Geoden, having the lowest risk potential. Patient taking these medications should receive frequent blood glucose monitoring, especially if they have risk factors for diabetes or already have diabetes, the FDA recommends.
Diuretics
Diuretics, which reduce fluid retention, can also cause hyperglycemia. Thiazide diuretics in particular may precipitate development of diabetes. Thiazide may cause hyperglycemia by decreasing potassium levels, according to the 2005 edition of "Hypertension: Principles and Practice." Loop diuretics such as Lasix can also cause hyperglycemia, but this occurs less frequently, and reverses when the drug is stopped.
Antihypertensives
Antihypertensive medications fall into several different classes, and several types can increase the risk of developing hyperglycemia. Direct-acting vasodilators such as minoxidil, which relax blood vessels, allowing more blood to flow through them, can cause hyperglycemia, Harvard Health Publications reports. Calcium-channel blockers and beta blockers may cause hyperglycemia, but this is not a common side effect; beta blockers can also cause low blood sugar, or hypoglycemia. Diazoxide, sold as Hyperstat, used for short-term treatment of severe hypertension can lead to hyperglycemia and coma.
Immunosuppressives
In addition to corticosteroids, other immunosuppressive medications can also induce hyperglycemia. Azathioprine, sold as Imuran, a medication used in autoimmune disease, can cause hyperglycemia, Family Practice Notebook reports, as can Cyclosporine-A, used to prevent organ rejection after transplant.
References
- Family Practice Notebook: Medication Causes of Hypergylcemia
- University of Maryland Medical Center: Bipolar Disorders-Medications
- Annals of Internal Medicine: Drug-Induced Disorders of Glucose Tolerance; Manjula Pandit et al; 1993
- "Hypertension: Principals and Practice": Informa Healthcare; Battegay, Bakris and Lip; 2005
- Harvard Health Publications: Medications for Treating Hypertension
